Developing competency in interns for endotracheal intubation: An educational article.

Background: Our existing undergraduate curriculum lacks developing competency for endotracheal intubation. Even though it is a lifesaving procedure, interns are exposed only during their posting in anesthesia or emergency medicine and so, when need arises, they fail to perform endotracheal intubation and it leads to catastrophes.

Aims And Objectives: The aim of this study was to develop competency in interns for endotracheal intubation.

Persistent cerebellar dysfunction following acute lithium toxicity: A report of two cases.

Neurological disturbances caused by lithium range from simple side effects such as benign tremor to acute reversible neurotoxicity. Rarely, lithium is reported to cause irreversible, permanent neurological sequelae most commonly manifested as cerebellar dysfunction, although other presentations have also been described. We report two cases of persistent cerebellar syndrome following acute lithium toxicity and discuss them in the light of existing literature on the subject.

Study of clinical and radiological profile and outcome in patients of intracranial hemorrhage.

Background: Incidence of intracerebral hemorrhage (ICH) is twice as high as in Western countries. Prognostic factors for predicting function outcome and mortality play a major role in determining the treatment outcome.

Methods: A prospective study of male and female patients ≥12 years with primary nontraumatic intracranial hemorrhage were included.

Transradial bilateral common iliac ostial stenting using simultaneous hugging stent (SHS) technique.

Current literature has limited reports of iliac artery interventions performed via transradial approach (TRA). We report four successive cases of bilateral common iliac ostial stenting using simultaneous hugging stent (SHS) technique through bilateral TRA. This technique allows the patient and the operator to exploit the benefits of TRA while treating this complex substrate.

Treatment outcome among cases of multidrug-resistant tuberculosis (MDR TB) in Western India: A prospective study.

Multidrug-resistant TB has become a significant public health problem in a number of countries and an obstacle to effective TB control. Therefore, the present study sought to determine the treatment outcome in patients with MDR TB in seven districts and to examine the factors affecting the treatment outcome. A prospective cohort study was carried out by enrolling all the registered patients in DOTs Plus center of Vadodara district from February 2010 to December 2010.

Comorbid Functional Shoulder Pain and Zolpidem Dependence Treated with Pramipexole.

Pramipexole is a dopamine agonist with higher affinity for D3 receptors. Treatment with pramipexole in clinical conditions such as restless legs syndrome, fibromyalgia, and parkinsonism has been found to significantly improve measures of pain and sleep along with the other symptoms. There is no research data available that explores the usefulness of pramipexole in somatoform/functional pain syndromes.

Antenatal diagnosis of aneurysmal malformation of the vein of Galen.

Vein of Galen malformation (VGAM) results from an aneurysmal aberration with an arteriovenous shunting of blood. Vein of Galen aneurysmal malformations are the most frequent arteriovenous malformations in infants and fetuses. The congenital malformation develops during weeks 6-11 of fetal development.

Validation of Gujarati Version of ABILOCO-Kids Questionnaire.

Background: ABILOCO-Kids is a measure of locomotion ability for children with cerebral palsy (CP) aged 6 to 15 years & is available in English & French.

Aim: To validate the Gujarati version of ABILOCO-Kids questionnaire to be used in clinical research on Gujarati population.

Materials And Methods: ABILOCO-Kids questionnaire was translated into Gujarati from English using forward-backward-forward method.

Changes in Capacity and Performance in Mobility Across Different Environmental Settings in Children with Cerebral Palsy: An Exploratory Study.

Background: Children with cerebral palsy, although having similar diagnosis, varies in their abilities & level of functioning within & across different environmental context e.g. home, school or community setting.

Radiation exposure in relation to the arterial access site used for diagnostic coronary angiography and percutaneous coronary intervention: a systematic review and meta-analysis.

Background: Transradial access for cardiac catheterisation results in lower bleeding and vascular complications than the traditional transfemoral access route. However, the increased radiation exposure potentially associated with transradial access is a possible drawback of this method. Whether transradial access is associated with a clinically significant increase in radiation exposure that outweighs its benefits is unclear.

Implementation of cardiopulmonary resuscitation workshop in first MBBS.

Context: Students should be exposed to early clinical scenario so that they start developing competency-based learning right from their MBBS 1(st) year. Medical Council of India has recognized this need and has suggested early clinical exposure of MBBS 1(st) year students in their document Vision 2015. Medical education in India needs change for achieving desired competencies.

Ketamine-induced affective switch in a patient with treatment-resistant depression.

There is growing evidence to support the rapid, albeit short-lived antidepressant effect of subanesthetic dose of ketamine, a noncompetitive glutamate N-methyl-D-aspartate receptor antagonist in treatment-resistant unipolar and bipolar depression. Ketamine is known to cause transient mood elevation or euphoria, psychotomimetic effects, and dissociative symptoms, but its use in unipolar or bipolar depression has not been reported to induce an affective switch amounting to persistent or prolonged hypomania/mania or manic-like syndrome. We report the case of a 52-year-old male with first episode, continuous, nonpsychotic, treatment-resistant, unipolar major depression of 10 years duration, who manifested a switch from depression to mania while being treated with subanesthetic dose of ketamine, given intramuscularly.

"Combo" technique for the use of 7F guide catheter system during transradial approach.

Even a regular lumen of radial artery may create difficulty in smooth negotiation and propagation of a 7F guide catheter while performing intervention through transradial approach. We describe successive five cases of a simple and innovative "Combo" technique, which helps relatively atraumatic tracking of a 7F guide catheter through the course of arm and chest vasculature for successful completion of procedure without significant damage and local pain.

Ultrasound guided Deep Vein cannulation: "Perpendicular Insertion Technique (PIT)", an edge over "Conventional Insertion Technique (CIT)".

Introduction: The use of ultrasound imaging before or during vascular cannulation greatly improves first-pass success and reduces complications, but this skill must then be combined with manual dexterity to perform the three dimensional (3D) procedure of placing a catheter into the deep veins while analyzing the 2D images. Hence this study is an attempt to still decrease the above mentioned limitation of guided deep vein cannulation by slight modification in the insertion technique.

Aims And Objectives: Aims to compare the ultrasound guided deep vein cannulation by conventional insertion technique(CIT) v/s ultrasound guided perpendicular insertion technique (PIT).

Assessment of the availability of technology for trauma care in Nepal.

Background: We sought to assess the availability of technology-related equipment for trauma care in Nepal and to identify factors leading to optimal availability as well as deficiencies. We also sought to identify potential solutions addressing the deficits in terms of health systems management and product development.

Methods: Thirty-two items for large hospitals and sixteen items for small hospitals related to the technological aspect of trauma care were selected from the World Health Organization's Guidelines for Essential Trauma Care for the current study.

Strategies to Traverse the Arm and Chest Vasculature.

This article discusses different methods of working through arm and chest vasculature to increase the success rate of the transradial approach (TRA). Despite lower rates of bleeding and vascular complications as compared with the transfemoral approach, adoption of the TRA has been slow, particularly because of higher failure rates. Anatomic complexities of arm and chest vasculature play an important role in cases of TRA failure.

Radial Artery Access, Hemostasis, and Radial Artery Occlusion.

Radial artery access is usually achieved using a micropuncture system. Hydrophilic introducers are used to improve comfort, probably by reducing spasm. A vasodilator cocktail should be administered to prevent severe spasm and anticoagulation; usually, unfractionated heparin is administered to prevent subsequent radial artery occlusion (RAO).

Off-label drug use in Psychiatry Outpatient Department: A prospective study at a Tertiary Care Teaching Hospital.

Introduction: Off-label drug prescribing is very common in Psychiatry. US-Food and Drug Administration has defined off-label drug as "use of drugs for the indication, dosage form, regimen, patient or other use constraint not mentioned in the approved labeling."

Objective: The objective was to evaluate off-label drug use in patients attending Outpatient Department of Psychiatry.

Medical students and interns' knowledge about and attitude towards homosexuality.

Background And Rationale: Medical professionals' attitude towards homosexuals affects health care offered to such patients with a different sexual orientation. There is absence of literature that explores the attitudes of Indian medical students or physicians towards homosexuality.

Aim: This study aimed to evaluate Indian medical students and interns' knowledge about homosexuality and attitude towards homosexuals.

Is off-label use a risk factor for adverse drug reactions in pediatric patients? A prospective study in an Indian tertiary care hospital.

Background: The lack of specific medicines and labeling recommendations for the pediatric population is a long-standing problem. Using data from an observational study of adverse drug reactions (ADRs) among pediatric inpatients, we aimed to test the hypothesis that off-label status is a risk factor for ADRs.

Methods: A prospective intensive surveillance was conducted at a pediatric ward of a public teaching hospital.